ata can be a challenge. With DB2 9, IBM introduced the
pureXML solution, which permits storage, indexing, and
querying of documents in their native XML format. Several
leading institutions have taken advantage of the native
XML capabilities of IBM DB2 to build systems that not only
exploit healthcare industry standards, but also improve
data access and performance.
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The challenge of electronic medical records
With sizeable amounts of rapidly and frequently changing
data, large healthcare organizations rely heavily on
XML. The UCLA Health System is one such organization: a multi-hospital healthcare provider with a diversity of clinical and healthcare applications. It includes
the Ronald Reagan UCLA Medical Center, Santa Monica
UCLA Medical Center and Orthopaedic Hospital, Mattel
Children’s Hospital UCLA, and Resnick Neuropsychiatric
Hospital at UCLA, as well as the UCLA Medical Group of
primary-care and specialty-care offices. The staff of more
than 2,000 physicians handles more than 1 million clinic
visits and 80,000 hospital visits per year.
A healthcare system of that size must process large
mounts of data on a daily basis, including medical records
updates; lab results; MRI, computed tomography (CT),
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HL7 has been developing standards designed to address HIPAA legislation
since 1996, when it formed a Claims Attachment working group to standardize
the information needed to process insurance claims. In that same year, HL7
began actively working with XML through its SGML/XML special interest
group. The initial deliverable was six recommended attachments for claims
processing.
Since then, HL7 has developed a specification for messaging, a Clinical
ocument Architecture (CDA), and a Reference Information Model (RIM). HL7
has also worked on a standard for electronic submission for CDA Public
Health Case Reporting (PHCR) to state and local public health departments.
As the standards matured, XML became an increasingly important
echnical component. For example, the first version of the CDA defined an
XML architecture for exchange of clinical documents based on XML Document
Type Definitions (DTDs) included in the specification with semantics defined
using the HL7 RIM and HL7 registered coded vocabularies. The upcoming
version 3 release of the CDA is expected to use only XML encoding.
“IBM DB2 native support of XML allows it to store content in the healthcare
dustry–standard HL7 CDA format,” says Karla Norsworthy, vice president,
software standards at IBM. “IBM is committed to healthcare interoperability
and innovation through open standards. We have seen the benefits of
flexibility, time to market, and innovation that come from widely adopted,
open standards such as Java, XML, and healthcare standards developed in
organizations such as HL7.”
